Mental exam plan put on hold

Spokane County commissioners have temporarily put on hold plans to overhaul the way mental health patients are evaluated.

The commissioners agreed Tuesday to extend through the end of the year Spokane Mental Health’s contract to handle initial evaluations. Over the next few months, a task force of mental health service providers will try to find the best way to stop the more than $1 million in fines the county has been paying to the state each year for admitting more patients to Eastern State Hospital than the state would prefer.

An earlier plan called for cutting Spokane Mental Health out of the process in an effort to save money.

The commissioners and Community Services Director Kasey Kramer have been at the center of controversy in the two weeks since they first openly discussed hiring managed-care firm United Behavioral Health to handle commitment screening services instead of Spokane Mental Health.

The new deal was brokered in part by Sacred Heart Medical Center, which admits mental health patients for hospitalization and evaluation from its emergency room.

Sacred Heart President Mike Wilson championed the idea Tuesday at a commissioners’ briefing on the subject, arguing that the problem may not be at the admission level.

“I’m sure that if any of you sat in our emergency room this Friday night, you’d agree that these people need to be hospitalized for the safety of our community,” Wilson said.

Even though they’re postponing a final decision on the issue until the task force’s work is complete, commissioners said that they are committed to stopping the fines one way or another.

It’s “goal one,” Commissioner Mark Richard said.

“When we exceed the cap, we pay dearly,” Commissioner Todd Mielke said.

Spokane Mental Health CEO David Panken said he thinks establishing a task force to study the issue is a good idea.

“Our board recommended to the county commissioners, independently of what Sacred Heart recommended, the same thing,” Panken said.

It’s unclear who will sit on the task force, but Commissioner Phil Harris urged Kramer to include at least one mental health services user and a representative from the county’s Veteran Services department.

Choosing the task force could become a highly charged political process. Feeling burned by the county, Panken sent a highly critical letter to the commissioners last week, and no one from Spokane Mental Health attended Tuesday’s meeting for fear of causing unnecessary conflict, he said.

During that meeting Wilson alluded to the tensions when a map fell off the wall onto his head. “I thought I might be attacked here this morning, but I didn’t know from where,” he joked.

Everyone at the meeting, however, agreed that the current system needs to be adjusted somehow.

“What we are doing is not working for the patient,” Harris said. “We’ve got to fix it.”